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Currently, the standard certification to work as a burns nurse is not very specific, however, some educational opportunities which provide essential skills and advance trainings are recommended in some burns care institutions, whilst others provide on-the-job training (Carlson, 2013). Due to the complexity of the problems of patients with burn injuries, the nurse must possess in-depth knowledge of multisystem organ failure, critical care and psychosocial skills as well as familiarity with the burns protocols which can be used to rationally manage a given situation (Greenfield, 2010). In this context the use of the nursing process, which includes problem solving techniques and decision making process, becomes a tool for rendering comprehensive and holistic care to burns victims.

The concept of caring is instrumental in supporting burns victims pass through the burns process swiftly. Knowledge and technical skills, coupled with caring attributes, contribute greatly to a successful burns care outcome. Ariely (2008:7), writes of a personal experience with a therapeutic burns intervention:

`The speed at which nurses remove the bandage is almost too fast for me. They hold on to the edge of the bandage and quickly strip it off. This method causes me

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a short, but intense pain as the bandage is removed, followed by a longer and more muffled pain`.

The nurses` compassion becomes a natural part of every client`s encounter and if they chose to avoid the clients` requests, the nurses` inaction will quickly convey an uncaring attitude (Potter & Perry, 2005:110). The question as to how much patients with burn injuries should be involved in decisions concerning their care remains uncertain considering that compassion has to be demonstrated in the midst of inflicting pain which is for the good cause. Ariely (2008:7) further writes:

`In addition to wanting to slow the removal process, I also want to break up the treatment and take a few short periods to calm down. The nurses and physicians are generally opposed to both of these suggestions. They argue that finishing the bath as fast as possible is the best approach for me.`

According to Morrow (2014), the intensity of pain can only be expressed by the one experiencing it. In burns care, pain persists throughout the burns care process to recovery. Nurses in the burns care team are duty bound to evaluate the sources of pain and institute appropriate relief measures in a caring manner. Ohmart (2013) writes that nurses advocate for patients` safety when they coordinate patient care delivered by multiple health care providers. As members of the burns care team, nurses are uniquely positioned to increase their effort to provide safe quality care to patients. `Although nurses continue to provide bedside care and being a calming influence for patients enduring the stress of illness, today`s nurses build relationship across the health care team on behalf of their patient, ` (Ohmart, 2013). In burns care, this implies that as a backbone of the burns care team, nurses are empowered to direct the course of the multidisciplinary team members` interventions towards the well-being of patients as part of their caring responsibility. Little is documented on nurses` influence within the multidisciplinary health

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care team. The current study therefore sought to explore the lived experiences of nurses working in a burns care multidisciplinary team system.

It is obvious the nurses` role is associated with promotion of comfort; however, inflicting pain on patients constitutes a great part of nurses` tasks in burns units as is seen during the implementation of the many painful treatment procedures. It therefore remains uncertain on how nurses can balance their role to care and cause pain in order to enhance recovery. It can be argued that the competency of balancing demonstration of compassion while inflicting pain is founded on the concept of caring.

Kornhaber (2009) conducted a study on the nurses` lived experiences of nursing severe burn patients in a burns ward in Sydney, Australia. The researcher carried out a descriptive phenomenological inquiry, where she interviewed seven full time registered nurses who shared their experiences in caring for the patients with burn injuries. The participating nurses described how they became hardened to the devastations of patients with burn injuries in order to enhance recovery. From the presented nurses` expressions, it was obvious that participants demonstrated hardiness in order to get the job done as reflected in the following views (Kornhaber, 2009:48):

`You know you cannot avoid that pain, but the only thing you can do is to just do it very quickly, so you need staff who can do it quickly instead of drag it on for many hours`.

Despite being hardened to get the job done, participants also demonstrated compassion by respecting humanity as demonstrated in the following expressions (Kornhaber, 2009:48):

`.... Yes they`ve got a wound... or they`ve got a burn but they`re still a person. So I don`t see the burn as the main thing. I see them as a person`.

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In this study, participants emphasised the importance of having the skills and knowledge to do dressings without traumatising the patients to help them pass through the burns care process swiftly. This approach helped to establish a mutual relationship between the nurse and the patients. On this aspect, the researcher concluded that the unique bond existing between the nurses and patients demonstrated a caring and trusting relationship which allowed the nurses to continue nursing the patients despite the painful treatment procedures they were exposed to.

In a related scenario, when interviewing burns nurses in a burns unit in Texas, nurses expressed that patients take on a new concept of care when a positive approach is demonstrated even when rendering painful treatment procedures (Wood, 2005). From this perspective, caring which originates from one`s feelings requires an action that demonstrates compassion. When caring is demonstrated, patients acknowledge nurses`

commitment that helps both parties enter into a therapeutic relationship which enhances recovery and well-being of care givers. In this study, creation of an accommodating environment for both patients and nurses was worth exploring from the nurses caring for burns victims in a burns unit within the African context, where provisions for burn care were expected to differ.